Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;27(27):2100865.
doi: 10.2807/1560-7917.ES.2022.27.27.2100865.

Using routine emergency department data for syndromic surveillance of acute respiratory illness, Germany, week 10 2017 until week 10 2021

T Sonia Boender  1 , Wei Cai  1 , Madlen Schranz  1   2 , Theresa Kocher  1   3 , Birte Wagner  1 , Alexander Ullrich  1 , Silke Buda  1 , Rebecca Zöllner  4 , Felix Greiner  5   6   7 , Michaela Diercke  1 , Linus Grabenhenrich  3
Affiliations

Using routine emergency department data for syndromic surveillance of acute respiratory illness, Germany, week 10 2017 until week 10 2021

T Sonia Boender et al. Euro Surveill. 2022 Jul.

Abstract

BackgroundThe COVID-19 pandemic expanded the need for timely information on acute respiratory illness at population level.AimWe explored the potential of routine emergency department data for syndromic surveillance of acute respiratory illness in Germany.MethodsWe used routine attendance data from emergency departments, which continuously transferred data between week 10 2017 and 10 2021, with ICD-10 codes available for > 75% of attendances. Case definitions for acute respiratory infection (ARI), severe acute respiratory infection (SARI), influenza-like illness (ILI), respiratory syncytial virus infection (RSV) and COVID-19 were based on a combination of ICD-10 codes, and/or chief complaints, sometimes combined with information on hospitalisation and age.ResultsWe included 1,372,958 attendances from eight emergency departments. The number of attendances dropped in March 2020 during the first COVID-19 pandemic wave, increased during summer, and declined again during the resurge of COVID-19 cases in autumn and winter of 2020/21. A pattern of seasonality of respiratory infections could be observed. By using different case definitions (i.e. for ARI, SARI, ILI, RSV) both the annual influenza seasons in the years 2017-2020 and the dynamics of the COVID-19 pandemic in 2020/21 were apparent. The absence of the 2020/21 influenza season was visible, parallel to the resurge of COVID-19 cases. SARI among ARI cases peaked in April-May 2020 (17%) and November 2020-January 2021 (14%).ConclusionSyndromic surveillance using routine emergency department data can potentially be used to monitor the trends, timing, duration, magnitude and severity of illness caused by respiratory viruses, including both influenza viruses and SARS-CoV-2.

Keywords: COVID-19; emergency service; hospital; public health surveillance; respiratory tract infections.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Weekly counts of emergency department attendances, between week 10 2017 and up to and including week 10 2021, Germany, 6 March 2017–13 March 2021 (n = 1,372,958)
Figure 2
Figure 2
Weekly counts of cases of (A) ARI, (B) SARI, (C) ILI, (D) RSV cases per 1,000 emergency department attendances, Germany, 6 March 2017–13 March 2021
Figure 3
Figure 3
Decomposed time series of the weekly counts of cases of (A) ARI, (B) SARI, (C) ILI and (D) RSV per 1,000 emergency department attendances, Germany, 6 March 2017–13 March 2021
Figure 4
Figure 4
Proportion of severe cases among acute respiratory infection cases, Germany, 6 March 2017–13 March 2021
Figure 5
Figure 5
Weekly counts of COVID-19 cases per 1,000 emergency department attendances, Germany, 6 March 2020–13 March 2021
See this image and copyright information in PMC

References

    1. Oh DY, Buda S, Biere B, Reiche J, Schlosser F, Duwe S, et al. Trends in respiratory virus circulation following COVID-19-targeted nonpharmaceutical interventions in Germany, January - September 2020: Analysis of national surveillance data. Lancet Reg Health Eur. 2021;6:100112. - PMC - PubMed
    1. Ullrich A, Schranz M, Rexroth U, Hamouda O, Schaade L, Diercke M, et al. Robert Koch’s Infectious Disease Surveillance Group . Impact of the COVID-19 pandemic and associated non-pharmaceutical interventions on other notifiable infectious diseases in Germany: An analysis of national surveillance data during week 1-2016 - week 32-2020. Lancet Reg Health Eur. 2021;6:100103. - PMC - PubMed
    1. World Health Organization (WHO) . Interpreting influenza surveillance data in the context of the COVID-19 pandemic. Wkly Epidemiol Rec. 2020;95(35):409- 15.
    1. European Centre for Disease Prevention and Control (ECDC). COVID-19 surveillance guidance - Transition from COVID-19 emergency surveillance to routine surveillance of respiratory pathogens. Stockholm: ECDC; October 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/covid-19-surveillance-gu...
    1. Bayer C, Remschmidt C, an der Heiden M, Tolksdorf K, Herzhoff M, Kaersten S, et al. Internet-based syndromic monitoring of acute respiratory illness in the general population of Germany, weeks 35/2011 to 34/2012. Euro Surveill. 2014;19(4):20684. 10.2807/1560-7917.ES2014.19.4.20684 - DOI - PubMed